This report covers progress and results by USAID and the Department of State from October 1, 2022, to September 30, 2023, and other key achievements to date.
Mental Health and Psychosocial Support (MHPSS) activities play a crucial role in achieving the development and humanitarian assistance goals of USAID and the Department of State, delivering life-saving assistance and improving everyday lives. Mental health affects physical health; child health and development; education outcomes; economic security; crime and citizen security; and workforce participation, among other areas. Poor mental health symptoms and conditions are directly associated with poor education outcomes; substance abuse and misuse; poor early childhood development outcomes; poor treatment uptake and outcomes for HIV, tuberculosis and other infectious diseases; increased incidence of non-communicable diseases, including heart disease and diabetes; poor nutrition; and poor maternal, newborn, and child health. Mental health symptoms and conditions also impact United States Government (USG) personnel, their partners, the service providers, and program implementers that we rely on and work with to drive development and humanitarian progress.
Over a lifetime and across all ages and genders, people live with mental health disorders longer than most physical illnesses, and mental and substance use disorders among children carry the highest burden. Evidence also shows that mental health conditions are higher among populations exposed to environmental stressors such as extreme poverty; war and conflict; food insecurity; high-levels of community violence and gender-based violence; and stigma and discrimination. Mental health is important to individual well-being as well as to social and economic progress. Failure to address mental health is often a hidden barrier to achieving development and humanitarian goals. Moreover, addressing mental health needs can accelerate progress, due to the connective and multi-directional nature of the relationship between mental health and development goals.
Recognizing the significance of children’s mental health to long-term well-being across the lifespan, USAID and the Department of State place particular importance on addressing the mental health needs of children and their caregivers. According to the World Health Organization (WHO), nearly 50 percent of mental health issues begin prior to age 14. Tragically, WHOreported in 2023 that suicide ranked as the fourth leading cause of death for young people aged 15 to 29, as well as a significant cause of mortality among those under 15. Suicide is one of the priority conditions in the WHO Mental Health Gap Action Program, and through the WHOMentalHealth Action Plan 2013–2030, member states have committed to reducing the suicide rate by one-third by 2030. Extensive research demonstrates that MHPSS interventions aimed at youth yield positive outcomes in terms of mental health and psychosocial well-being.
Agrowing body of evidence supports the effectiveness, including cost-effectiveness, of both mental health and psychosocial support interventions across the lifespan. WHO estimates that investing in the treatment of anxiety and depression alone results in a fourfold return. In adolescents, the return from preventing and treating mental health disorders and suicide among adolescents is even greater, yielding $24 for every $1 invested. Moreover, the benefits of mental health programming are not limited to health. As demonstrated in a study evaluating poverty reduction interventions, those that included psychosocial support not only improved economic outcomes but were also the most cost effective9. Additionally, Innovations for Poverty Action recently cited cognitive behavioral therapy and couples counseling as two of their “best bets” on emerging opportunities for reducing crime and intimate partner violence at scale.
This year’s report illustrates the immense progress USAID and the Department of State have madein not only responding to the growing need for MHPSS activities in foreign assistance, but also an elevation of Mental Health across the agencies to expand and better coordinate programming efforts within and between the agencies.